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1174891790
MISTY MICHELLE GROOM
BEND, OR
NPI
1174891790
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Former Name
MISTY MICHELLE PEDERSON
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2011-12-09
Last Update Date
2011-12-09
Business Address
-- MISTY MICHELLE GROOM
2577 NE COURTNEY DR
BEND, OR 97701-7638
Phone number: 541-322-7500
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Mailing Address
-- MISTY MICHELLE GROOM
2577 NE COURTNEY DR
BEND, OR 97701-7638
Phone number: 541-322-7500
Copy
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